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Assessing ADHD Symptoms in Children and Adults: How Can the CAT-A and CAT-C Help You with Evaluating ADHD?
If you’ve noticed an uptick in the number of patients seeking care for ADHD in recent years, you’re not alone. Research has shown a dramatic increase in ADHD diagnoses over the last two decades, with an even greater spike during and after the COVID-19 pandemic. This rise has been linked to a variety of factors, including:
- More access to information
- Destigmatization of mental health
- Social media awareness
- Loss of routine and structure during the pandemic
- Improved healthcare resources
Another recent shift in ADHD diagnoses has been the number of adults receiving a diagnosis. While ADHD used to be associated mainly with children, it is now viewed as something that can impact adults as well—and to a greater degree than previously thought. The CDC has reported that, in 2023, an estimated 15.5 million (or roughly 6%) adults in the U.S. had a current ADHD diagnosis, with approximately one half having received that diagnosis during adulthood.
The staggering numbers that represent ADHD today have led to questions about whether the condition is being over diagnosed, although others have argued that it is still under diagnosed. There are also many other conditions with similar symptoms to those of ADHD, and these conditions can exist either separately or as comorbidities. This points us towards the importance of understanding and accurately measuring the symptoms of ADHD, as doing so is essential to providing the right diagnosis and treatment.
In this article, we will discuss issues in diagnosing ADHD, the challenges that patients and providers are now facing, and how the CAT-A™ and CAT-C™ assessment tools from PAR can be instrumental in supporting individuals who may have ADHD.
The Symptoms of ADHD
ADHD is one of the most common neurodevelopmental disorders. There are three types of ADHD, these being:
- Combined – Characterized by a combination of impulsive and hyperactive behaviors as well as difficulty paying attention and getting easily distracted, this is the most common type of ADHD.
- Predominantly inattentive – This type is characterized mainly by symptoms like inattentiveness and being easily distracted.
- Predominantly impulsive-hyperactive – Those with this type of ADHD exhibit impulsive and hyperactive behaviors, but do not have difficulty paying attention. It is the least common type of ADHD.
Symptoms of the condition, regardless of type, develop during childhood. In most cases, these symptoms (approximately 60%) last into adulthood. They can manifest differently over time, especially as individuals develop and learn new management strategies, which is likely the reason that some adults notice a reduction in their symptoms. According to the CDC, common signs of ADHD in children include:
- Frequent daydreaming
- Forgetting/losing things often
- Difficulty resisting temptations
- Taking careless risks
- Having trouble taking turns or getting along with others
- Squirming, fidgeting, or difficulty sitting still
- Talking too much
In both children and adults, ADHD can also cause problems with executive functioning. This can make it difficult for individuals to plan, organize, and finish tasks. In adults with ADHD, these executive functioning differences can impact the ability to complete job-related tasks and follow deadlines, which may lead to employment obstacles.
Issues with ADHD Diagnoses
Adults and children alike are being diagnosed with ADHD in greater numbers than ever before, but this increase has not necessarily made it easier to receive treatment. Many patients with ADHD struggle to get ahold of prescribed medications due to shortages and restrictions of certain stimulants used to treat ADHD, such as Adderall and Vyvanse. There have also been changes to who can prescribe these medications in certain states, putting a strain on patients and providers alike.
Considering these additional barriers to receiving treatment, it’s essential for patients and/or their parents to know what to do if they are considering care for ADHD. Having the right diagnosis is paramount, which is where psychological assessment tools come into play.
Benefits of Using the CAT-A to Assess for ADHD
An ADHD diagnosis must be made by a certified mental health professional, and the process can take several steps. Perhaps the most important step of the process is using specialized tests to assess the patient’s symptoms. While there is no singular test that can be used for assessing ADHD, the Clinical Assessment of Attention Deficit Adult & Child (CAT-A/CAT-C) is one that many mental health professionals rely on for its applicability and dependability. Designed to assess behaviors that correspond to DSM-IV, the CAT-A and CAT-C provide a comprehensive view of the associated symptoms an individual exhibits.
The CAT-A is a 108-item self-report instrument that is sensitive to the symptomatology of attentional deficits both with and without hyperactivity for adults. It includes a variety of features and benefits that make it especially useful for assessing adults, such as:
- A test divided into two parts: Part 1 (Childhood Memories) assesses the individual’s memories of his or her behaviors and sensations as a child; Part 2 (Current Symptoms) assesses parallel issues in adulthood.
- Three validity scales: Negative Impression, Infrequency, and Positive Impression—are embedded within the instrument.
- Linkage to DSM-IV diagnostic criteria with comprehensive content coverage both within and across scaled/clusters to assist you in rendering differential diagnoses.
- Context clusters that indicate contexts in which ADD/ADHD symptoms are most problematic, as well as locus clusters that indicate the extent to which ADD/ADHD symptoms are experienced internally as sensations or experienced as symptoms on which overt behaviors are acted.
- Items that target clinical symptoms (inattention, hyperactivity, and impulsivity) and multiple contexts (school/work, social, and personal).
- Differentiates sensations (internal) from actions (external).
The CAT-C includes many of the same features and benefits as the CAT-A, but it is specifically tailored to measure ADHD symptoms in children. This 42-item assessment instrument stands out for a variety of reasons, including:
- The CAT-C uses three parallel forms to acquire accurate reports of symptoms: a Self-Rating Form, a Parent Rating Form, and a Teacher Rating Form.
- The instrument is standardized on a sample of 800 children and adolescents (ages 8-18 years), 800 matched parents of these children, and 500 teachers of these children.
- Concurrent validity, assessed through comparison with the Conners’ Rating Scales, the ADHDT, the CAB™, and the CAD™, revealed moderate-to-high correlations for both nonclinical and combined clinical samples across all three rating forms of the CAT-C.
By using the CAT-A and CAT-C in your assessments, you are able to get a broad view of a patient’s symptoms and how these symptoms may be affecting their day-to-day activities.
See How You Can Benefit from Using the CAT-A and CAT-C
ADHD is a lifelong condition, which makes it even more important to provide the right interventions and treatment recommendations as early as possible. Discover how the CAT-A and CAT-C from PAR can change how you assess for ADHD and improve patient outcomes.
Sources:
https://healthcare.utah.edu/healthfeed/2024/06/why-adult-adhd-rise
https://prairie-care.com/resources/type/blog/rise-of-adult-adhd/
https://www.psychologytoday.com/us/blog/balanced/202302/why-is-the-prevalence-of-adhd-increasing